[lbo-talk] broken like for healthcare follies

Chuck Grimes cgrimes at rawbw.com
Sat Jul 5 20:24:39 PDT 2008


"I do not intend to question the value of markets here today, but rather to compare how markets ideally work with the market for health care. Economists, such as Hayek, have long contended that markets can efficiently generate and process information, but medical care presents a number of problems for market efficiency. To begin with, in Hayek's market, people have sufficient information to make informed decisions. Health care does not look like a Hayek market...'' MP

I would take a different approach with the beginning premise. It is always important to outline the context, the universe of discourse within which the debate is framed. In this context the assumption is that markets are the natural place for any healthcare debate. But that is not the case. The case is that healthcare as a social good supercedes markets. (I still haven't installed a spell checker so bare with me... I did get TeX up and running...)

To illustrate, consider the debate that primary education should become a market comodity. Most of us do not believe that. We instead assume that primary education is a social good that must supercede the so-called social good of markets, and that is precisely why primary education is given over to the state. In this context we do not call education, socialized educaton, we call it public education. We further assume that this public good, supercedes the private good of making a profit out of teaching and housing little kids...

So, I would reframe the question, is it in the public good, for private corporations to make a profit from the illness, disease, disablity, and death of the population who make up the public body? Clearly my answer is no. But futhermore, it is becoming apparent that the only way to make a profit from the diseases, illnesses, and deaths of the population, it is that healthcare providers limit access to care because there is simply not enough money made off the healthy to pay for the sick, and still show an acceptible bottom line. In other words, privatizing healthcare doesn't work for the larger social good of society or for the private good of the corporation. This is essentially why most observers both inside and outside the heathcare industry complain the system is failing. That is it fails to provide sufficient profit and it certainly falls far short of providing acceptible healthcare to the public.

Moreover, while we are all aware of the inefficiencies of our privatized healthcare system, few are aware of the systematic erosion of Medicare as a public service provider. The stunning fact is that while private providers are falling short of their bottom line, the public system has been turned into a corporated minded public service more concieous of meeting its endless budget short falls, than providing the services it is legally mandated to provide. In effect Medicare has long ago become a public service provider that engages in just as egregious denial of service claims as any private sector provider. In fact Medicare leads the way to all the various categories of denial of service---which the private providers follow in earnest. The US government simply does not want to accept the idea that so much of its population are old and have conditions that require medical service. In short Medicare (as a consequence of endless tax cut battles) is just as broken as its private provider sector in the so-called free market.

``A follower of Hayek would never consider adequate health care as a human right, but I do. As such, a distribution of income that puts access to health care out of reach for millions of people represents a significant market failure.'

This is precisely why we need to question the position of healthcare as a public good, prior to developing a debate. The question is do you believe you have a right to a life free of disease and illness? I think the UN charter lists this as a human right. Certainly the declaration of independence does in an indirect way, in the phrase ``We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that mong these are Life, Liberty and the pursuit of Happiness -- That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed...''

One is hardly at Liberity or in the pursuit of happiness, if you are sick and languishing in an isolated apartment in a giant urban center... In other words it is a human right not to live in such conditions.

And it should be apparent by now that the freemarket system whatever its great virtues ( I find few myself, but grant any you wish to name), can not solve all the problems of the human cndition. Such an economic system was never intended to be the one stop shop for all social good. So, then, we can see the freemarket is in fact failing to provide the best of solutions to the universally aknowledged social good and human right to a healthy life.

Hope this helps somewhere..

CG



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